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Online Membership Form

Thank you for giving to Ozark Land Trust. Please fill out the form below and note that any gift over $35 enrolls you in an OLT membership for the current calendar year!

You may also sign up for automatic membership renewal and even give a membership as a gift to a loved one. Please email larry.levin@ozarklandtrust.org with any questions.

Membership Level

$5,000 - Guardian

$1,000 - Visionary

$500 - Supporter

$250 - Protector

$100 - Steward

$60 - Friend

$35 - Contributor

Is this a One Time gift? Or, would you like to sign up for automatic renewal of your Annual Membership?

When would you like you ORLT membership to expire?

(mm/dd/yyyy)

Your Contact Information

Name

First Name

Last Name

Address

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Is this Membership a gift for someone else?

Yes

Would you like us to inform the person about your Membership Gift?

Yes

Name of Gift Membership Recipient

First Name

Last Name

Address of Gift Membership Recipient

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Address Line 2

City

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Email of Gift Membership Recipient

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Is this Donation a Tribute?

Yes

Name of Tribute/Honoree

First Name

Last Name

Tribute message

Would you like us to inform someone about your donation?

Yes

Name to be notified

First Name

Last Name

Address

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Address Line 2

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State/Province

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